Does patient have any previously documented urinalysis

This is an important question, because most cases of incidentally discovered proteinuria resolve within a few weeks.

B. Any history of facial swelling, increased abdominal girth, or leg edema? Any of these symptoms would raise the possibility of nephrotic-range proteinuria, which, in turn, is a sign of significant renal disease.

C. Any history of constitutional symptoms or signs (intermittent fever, rash, abdominal pain, mouth sores, lymphade-nomegaly, joint symptoms, weight gain or loss)? These symptoms and signs could be features of significant underlying disease causing proteinuria (eg, systemic lupus erythematosus, hemolytic uremic syndrome, Henoch-Schonlein purpura, among others).

D. Has patient ever had gross hematuria (red, brown, or pink urine)? History of brownish urine, along with proteinuria, should be considered as a sign of glomerular renal disease until proven otherwise. Fresh blood (red or pink, with or without clots) is most likely of lower urinary tract origin and is probably unrelated to presence of protein. Only a large amount of blood in urine will cause noticeable proteinuria; never microscopic hematuria.

E. Does patient have a history of recent strep throat or skin infection? Acute postinfectious glomerulonephritis (APIGN) can go unnoticed and may cause persistent proteinuria for up to 4-6 months.

F. Is there a family history of kidney disease? The few familial renal conditions that may need to be considered are Alport disease, juvenile nephronophthisis, polycystic kidney disease, and, in newborns and infants only, congenital nephrotic syndrome.

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